Essure safe in combo with endometrial ablation.(Gynecology)

SAN FRANCISCO -- The Essure sterilization procedure can be used in combination with two methods of endometrial ablation, according to studies presented at the annual meeting of the American Association of Gynecologic Laparoscopists.

The Essure procedure may be performed immediately before or immediately after using the ThermaChoice uterine balloon ablation system. It also can be done immediately after--but not immediately before--using the NovaSure radiofrequency ablation system, investigators reported.

The Food and Drug Administration approved the use of the Essure system with ThermaChoice ablation in July 2004. The agency has not approved the use of Essure with NovaSure, and a spokesperson for Conceptus Inc., which distributes Essure, told this newspaper that the company has no plans to apply for such approval.

"The majority of women who undergo endometrial ablation are in their reproductive years, so many of them request Essure sterilization to control fertility after or during endometrial ablation," Rafael F. Valle, M.D., a consultant for Conceptus, reported.

"Because these two methods utilize the same approach, the transvaginal approach, they can be performed concomitantly," said Dr. Valle of Northwestern University, Chicago.

In his study, 40 women who were about to undergo hysterectomy for benign uterine bleeding consented to ThermaChoice endometrial ablation before or after placement of the Essure microinserts. Their average age was 43 years.

The microinserts were placed before ablation in 24 of the women, and in 16 of these women the combined procedure was successful. In the other eight, gross uterine pathology prevented proper placement of the microinserts.